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Gender-specific characteristics and predictors of mortality in a prospective study of nursing home patients

The Union Institute. PHD thesis

Author: Jackson, M. N. M.
Type: Journal Article
Year: 1995

Abstract:

The PDE continued analysis of almost 30,000 records on 666 patients admitted to a California nursing home over a 3-year period. Data were collected as part of a National Institute on Aging Teaching Nursing Home Award to the University of California San Diego and San Diego State University (1984-1990). The specific aims were to determine characteristics and predictors of death. Of the 666 subjects, 230 were classified as dead and 436 as alive. Epidemiologic and statistical methods were used to analyze data that were interpreted in a sociological context. These analyses resulted in two manuscripts for submission to peer-reviewed professional journals. The mortality rate was 35% with differences between the 165 men (41%) and 501 women (32%). In a Cox proportional hazards survival analysis, ambulation ability was the only significant predictor for both men and women (hazard ratios (HR) of 1.30 and 1.24, respectively). Women with cancer (HR 2.57), married vs. other marital status (HR 1.90), and impaired skin integrity (HR 1.50) had a higher probability of death; whereas men with digestive disorders (HR 0.37), hip surgery vs other surgery or no surgery (HR 0.25) and fractures other than hip (HR 0.24) had a higher probability of survival. Gender-specific analysis of short-stay (< 50 days) and long-stay (>/= 50 days) subjects also identified distinct differences. More men than women were admitted from home, and hip surgery was most common among short-stay women. Only 13 subjects died at home, with 177 deaths in a nursing home and 40 in a hospital. The complex patterns of movement between nursing homes, hospitals, and home, evident in this and other studies, make it imperative for policy makers to broaden perspectives on gender-specific differences and a continuum of care that does not separate and fragment acute and chronic needs and services.

Further Details

Pages: 94 p.
Volume: 94
Accession Number: 8.5.03
Keywords: North America, older
Reads: 122
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